Provider Demographics
NPI:1942621065
Name:KNIGHT COUNSELING AND CONSULTATION SOLUTIONS
Entity Type:Organization
Organization Name:KNIGHT COUNSELING AND CONSULTATION SOLUTIONS
Other - Org Name:MOSAIC WELLNESS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:STEPHANIE
Authorized Official - Middle Name:KNIGHT
Authorized Official - Last Name:CLARKE
Authorized Official - Suffix:
Authorized Official - Credentials:MA, LPC
Authorized Official - Phone:304-546-4640
Mailing Address - Street 1:209 WASHINGTON ST W STE 200
Mailing Address - Street 2:
Mailing Address - City:CHARLESTON
Mailing Address - State:WV
Mailing Address - Zip Code:25302-2348
Mailing Address - Country:US
Mailing Address - Phone:304-546-4640
Mailing Address - Fax:304-205-4054
Practice Address - Street 1:216 WASHINGTON ST W
Practice Address - Street 2:
Practice Address - City:CHARLESTON
Practice Address - State:WV
Practice Address - Zip Code:25302-2346
Practice Address - Country:US
Practice Address - Phone:304-546-4640
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-12-16
Last Update Date:2024-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV2020101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV12433876OtherCAQH